2021-10-19T15:25:20-05:00 2020-12-31 930743240 HOFFMAN STEWART & SCHMIDT PC 3 CENTERPOINTE DRIVE SUITE 300 LAKE OSWEGO OR 970358663 990 2020-01-01 910896241 COWLITZ FAMILY HEALTH CENTER COWL 3606363892 1057 12TH AVENUE LONGVIEW WA 986322509 JIM COFFEE EXECUTIVE DIRECTOR 3606363892 2021-10-18 1 JIM COFFEE 999009999 TODD D MASSINGER P00075883 5032205900 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JIM COFFEE 1057 12TH AVENUE LONGVIEW WA 986322509 22582857 0 X WWW.COWLITZFAMILYHEALTH.ORG X 1972 WA EVERYONE DESERVES HIGH-QUALITY COMPASSIONATE CARE. WE PROVIDE COMPREHENSIVE HEALTH SERVICES AND EDUCATION, REGARDLESS OF CIRCUMSTANCES OR INCOME. TOGETHER WE IMPROVE QUALITY OF LIFE AND TRANSFORM OUR COMMUNITIES. 11 11 257 11 0 0 5420822 7379006 17753783 14984536 -18009 39601 288124 179714 23444720 22582857 0 0 0 0 15690274 15662899 0 0 0 8460842 7523838 24151116 23186737 -706396 -603880 22417472 21415629 3520327 3122364 18897145 18293265 X EVERYONE DESERVES HIGH-QUALITY COMPASSIONATE CARE. WE DO THIS BY PROVIDING COMPREHENSIVE HEALTH SERVICES AND EDUCATION, REGARDLESS OF CIRCUMSTANCES OR INCOME. TOGETHER WE IMPROVE QUALITY OF LIFE AND TRANSFORM OUR COMMUNITIES. 0 0 9847863 11273942 TO PROVIDE MEDICAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL MEDICAL ENCOUNTERS DURING THE YEAR WERE 54,951. 3460101 1942429 TO PROVIDE DENTAL SERVICES TO LOW INCOME INDIVIDUALS. THE TOTAL DENTAL ENCOUNTERS DURING THE YEAR WERE 13,182. 564237 TO PROVIDE SUPPLEMENTAL NUTRITION SERVICES FOR PREGNANT AND BREASTFEEDING WOMEN AND THEIR CHILDREN TO AGE 5. DURING 2020, THE CENTER SERVED 4,207 WOMEN, INFANTS, AND CHILDREN. 4718791 1947879 TO PROVIDE MEDICAL RELATED SERVICES TO LOW-INCOME INDIVIDUALS. ENABLING SERVICE ENCOUNTERS AND MENTAL HEALTH ENCOUNTERS (INCLUDING SUBSTANCE USE DISORDER SERVICES) TOTALED 8,061 AND 4,640, RESPECTIVELY. 4718791 1947879 18590992 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 0 1 257 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WA X KATHERINE LIM-PEDERY 3607036701 1057 12TH AVENUE LONGVIEW WA 98632 STAR GARCIA DIRECTOR 2.00 X 0 0 0 QUINCY SHINNICK DIRECTOR 2.00 X 0 0 0 DEBORAH IDLETT DIRECTOR 2.00 X 0 0 0 DAVID MCCLAY DIRECTOR 2.00 X 0 0 0 JOHN PAUL PRADO DIRECTOR 2.00 X 0 0 0 MARK GAITHER DIRECTOR 2.00 X 0 0 0 LILLY TERRY DIRECTOR 2.00 X 0 0 0 MARK NELSON PRESIDENT 2.00 X X 0 0 0 WANDA MCBEE SECRETARY 2.00 X X 0 0 0 CYNTHIA WASHINGTON-MATTSON VICE PRESIDENT 2.00 X X 0 0 0 SANDRA BENBROOK-RIEDER TREASURER 2.00 X X 0 0 0 DIAN COOPER CEO 32.00 X 176327 0 14694 JAMES COFFEE COO/DEPUTY DIRECTOR 40.00 X 134959 0 14110 KATHERINE PEDERY CFO 40.00 X 120311 0 13052 GERALDO MELGAR MEDICAL DIRECTOR 40.00 X 276000 0 10790 ERIC GURRAD DENTIST 40.00 X 173856 0 14626 PARAMJIT GILL DENTIST 36.00 X 164654 0 9410 ANTHONY REYES ASSOCIATE MEDICAL DIRECTOR 40.00 X 215284 0 15664 GAIL CONWAY PHYSICIAN 36.00 X 197040 0 12069 MIN LEE PHYSICIAN 40.00 X 191223 0 14684 TRESHA CARROLL PHYSICIAN 32.00 X 187431 0 9410 DAVID MEYERS DENTAL DIRECTOR 40.00 X 178564 0 14207 2015649 0 142716 24 0 1 0 OCHIN INC 1881 SW NAITO PARKWAY PORTLAND OR 972015195 EMR AND PRACTICE MANAGEMENT FEES 1445947 MCKESSON MEIDCAL SURGICAL INC PO BOX 933027 ATLANTA GA 311933027 MEDICAL PRODUCT DISTRIBUTOR 1030104 POLAR SYSTEMS INC 21890 WILLAMETTE DRIVE WEST LINN OR 97068 IT SERVICES 628270 STAFF CARE INC PO BOX 281923 ATLANTA GA 303841923 LOCUM TENENS 415103 ABM JANITORIAL SERVICES INC PO BOX 419860 BOSTON MA 022419860 JANITORIAL SERVICES 382702 8 6227146 1151860 7379006 PATIENT SERVICE REVENUE 624100 7003380 7003380 PREMIUM REVENUE AND INCENTIVE 624100 6885721 6885721 PHARMACY FEES 624100 1042035 1042035 PROGRAM SERVICE REVENUE 624100 53400 53400 14984536 39421 39421 180 0 180 180 180 RISK POOL REVENUE 900099 123385 123385 OTHER 900099 56329 56329 179714 22582857 15164250 0 39601 X 760243 286790 473453 12076210 10490289 1585921 169861 153832 16029 1788733 1529208 259525 867852 730889 136963 151565 151565 63178 63178 2735529 1482813 1252716 1923 1552 371 797653 452748 344905 1744424 1613706 130718 25662 20138 5524 28884 22667 6217 37883 30906 6977 459614 424993 34621 169496 146732 22764 CLIENT ASSISTANCE 680748 680110 638 MEDICAL SUPPLIES 293000 293000 DUES & SUBSCRIPTIONS 93167 53782 39385 RECRUITMENT & RETENTION 68119 48301 19818 172993 128536 44457 23186737 18590992 4595745 0 6445098 4870794 5720189 6019774 341855 881804 3466945 3515365 142814 208492 174607 164908 12197249 6442757 6125964 5754492 22417472 21415629 1921404 1551817 1598923 1570547 3520327 3122364 X 18869984 18266318 27161 26947 18897145 18293265 22417472 21415629 -603880 0 X X 0 1 X 1 1 1 X 4577613 4776617 4801227 5420822 7379006 26955285 4577613 4776617 4801227 5420822 7379006 26955285 26955285 3854 4479 9429 -18009 39421 39174 17599 24369 28036 288124 179714 537842 27532301 93443289 0.97900 0.98460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 685979 685979 4755225 780066 3975159 2718423 2383478 334945 3948592 3213755 734837 89030 65458 23572 5754492 X 22531181 0 22531181 51676 51676 22582857 23135061 0 23135061 51676 51676 23186737 PART X, LINE 2: MANAGEMENT OF COWLITZ FAMILY HEALTH CENTER DOES NOT BELIEVE THE CENTER HAS ANY UNCERTAIN TAX POSITIONS. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT EXPENSE 51,676. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT EXPENSE 51,676. X X 0 0 0 0 0 0 0 0 0 GERALDO MELGAR MEDICAL DIRECTOR 276000 0 0 0 0 0 1380 0 9410 0 286790 0 0 0 ANTHONY REYES ASSOCIATE MEDICAL DIRECTOR 215284 0 0 0 0 0 6724 0 8940 0 230948 0 0 0 GAIL CONWAY PHYSICIAN 197040 0 0 0 0 0 3152 0 8917 0 209109 0 0 0 MIN LEE PHYSICIAN 191223 0 0 0 0 0 5744 0 8940 0 205907 0 0 0 TRESHA CARROLL PHYSICIAN 187431 0 0 0 0 0 0 0 9410 0 196841 0 0 0 DAVID MEYERS DENTAL DIRECTOR 178564 0 0 0 0 0 5290 0 8917 0 192771 0 0 0 DIAN COOPER CEO 176327 0 0 0 0 0 5290 0 9404 0 191021 0 0 0 ERIC GURRAD DENTIST 173856 0 0 0 0 0 5216 0 9410 0 188482 0 0 0 PARAMJIT GILL DENTIST 164654 0 0 0 0 0 0 0 9410 0 174064 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE COMMITTEE AND THE FULL BOARD OF DIRECTORS MUST REVIEW THE DRAFT FORM 990 PRIOR TO SUBMITTAL. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION INQUIRES ABOUT CONFLICTS OF INTEREST AT INITIAL INTERVIEWS WITH CANDIDATES FOR EMPLOYMENT AND BOARD MEMBERS ARE REQUIRED TO SIGN A STATEMENT OF DECLARATION OF ANY CONFLICTS OF INTEREST. BOARD MEMBERS ARE REQUIRED TO FILL OUT AN ANNUAL CONFLICT OF INTEREST FORM. FORM 990, PART VI, SECTION B, LINE 15A THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE CEO'S PAY BASED ON PERFORMANCE AND COMPARABLE MARKET SALARIES. COMPENSATION FOR KEY EMPLOYEES ARE REVIEWED AND APPROVED BY THE CEO BASED ON PERFORMANCE AND COMPARABLE MARKET SALARIES. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,482,813. MANAGEMENT AND GENERAL EXPENSES 1,252,716. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,735,529. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE PROCESS FROM THE PRIOR YEAR REGARDING THE OVERSIGHT OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANTS' THAT AUDIT THE FINANCIAL STATEMENTS OF THE ORGANIZATION.